We are an equal opportunity employer, dedicated to a policy of non-
discrimination in employment on any basis including race, color
creed, religion, national origin, sex, pregnancy, marital status,
disability, age, status with regard to public assistance or sexual
preference or identity.

Name:

Date:

Present Address

Permanent Address

Street Address:

Street Address:

City

Are you 18 years of age or older?

Yes No

City

State/Province:

State/Province

Zip/Postal Code:

Zip/Postal Code:

Home phone:

Cell phone:

Email Address:

Referred By:

Positions applied for:

Salary desired:

Full-Time Regular On-Call Temporary Summer Project

Hours available for Work:

First Shift Second Shift Third Shift

First Available Work Day:

Last available work day (Summer Project Only)?

Education

Type of School

Name of School and Complete Mailing Address

# of Years Completed

Major or Degree

High School

College, Bus. or
Trade School

Professional School

Other

Previous Employment (list up to 3)

#1.

Name of Employer:

Complete Address:

Phone #:

Last Job Title:

Name of last supervisor:

Dates of Employment, From:

To

Salary, From:

To

Reason for leaving (be specific):

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

May we contact your employer:

Yes No

#2.

Name of Employer:

Complete Address:

Phone #:

Last Job Title:

Name of last supervisor:

Dates of Employment, From:

To

Salary, From:

To

Reason for leaving (be specific):

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

May we contact your employer:

Yes No

#3.

Name of Employer:

Complete Address:

Phone #:

Last Job Title:

Name of last supervisor:

Dates of Employment, From:

To

Salary, From:

To

Reason for leaving (be specific):

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

May we contact your employer:

Yes No

Please list 2 references other than relatives and previous employers.

Reference #1

Name:

Occupation:

Years Known Applicant:

Telephone:

Reference #2

Name:

Occupation:

Years Known Applicant:

Telephone:

If you are hired, you will be required to present documents that establish identity for employment in accordance with
the immigration Reform and Control Act of 1986 (8. U.S.C. 1324a). (i.e.; U.S. Passport, Social Security Card, Driver’s
License with photo or other acceptable identification as required by the act.)

Applicant Statement

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete,
and correct. I understand that any information provided by me that is found to be false, incomplete or misrepresented
in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge
me from the employer’s service, whenever it is discovered. I voluntarily give the company the right to conduct a
complete background investigation and agree to cooperate in such investigation and release from all liability or
responsibility all persons, companies or organizations giving such information. I understand that Sentinel Printing Co,,
Inc. retains the right to terminate its employees at any time for any reason not prohibited by law and, if hired, I
understand that I am free to resign at any time for any reason subject to Sentinel Printing Co., Inc.’s, notice
requirements and that these mutual rights constitute Sentinel Printing Co., Inc.’s at will policy. Furthermore, I
understand no officer, management official or employee is authorized to make any oral assurance regarding any
condition of employment, including, but not limited to, a promise of continued employment. I further acknowledge and
understand that, if I am employed, Sentinel Printing Co., Inc. has the right, at any time and for any reason, to make
changes in all employment policies, instructions, and procedures with or without notice and that I am required to abide
by all rules and regulations of the company. I realize that this application remains current for 6 months. At the
conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be
necessary to fill out a new application.
DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.
I certify that I have read, fully understand, and accept all terms of the foregoing Applicant Statement.